On the rich trail of life’s ups and downs

AT the end of the 1990s, a massive research project began tracking the health and wellbeing of nearly 7500 people randomly plucked from Canberra and Queanbeyan, through 20 years of life’s ups and downs.

Researcher Peter Butterworth… “Mental health at a community level, I think, provides some sort of a marker of how well a society’s doing, overall.” Photo by Gary Schafer

Three groups, aged in their early 20s, 40s and 60s at the start, answer long questionnaires and undergo physical and cognitive tests every four years, to build an immensely valuable data set that has already led to nationally and internationally significant research findings, and will continue to long after it’s finished.

Called “Personality and Total Health (PATH) Through Life”, it involves five official sub-studies and has given rise to more than 170 published scientific papers, at least 12 major reports and about 30 PhD projects.

Associate Professor Peter Butterworth, one of the study’s principal investigators from the ANU Centre for Research on Ageing, Health and Wellbeing, explains that PATH looks at the “total health” of people and how that changes over the adult lifespan by focusing on three main health domains: depression and anxiety, alcohol, tobacco and drug use, and the course of age-related cognitive decline and dementia.

“The key is to understand, in all of these conditions and disorders, what the factors are that make people more likely to experience them in the end,” says Butterworth.

“You can’t get that just by focusing on a clinical population who are already experiencing dementia, depression or anxiety.

“You need to follow people from beforehand and identify lifestyle factors like whether or not people are exercising, their diet… smoking and all these other factors as well, so the advantage of following people over an extended period of time is we can look at the characteristics and life experiences that people typically have, and how those lead to, or protect them against those adverse outcomes in the long run.”

A benefit to Canberra is that the ACT Government gets more detailed health data for our local community than most municipalities could ever hope for.

In 2011, the latest PATH report on the ACT’s mental health and wellbeing showed, among many other things, that dangerous drinking was most common among middle-aged women, and that while suicidal thoughts are common, affecting over six per cent of locals, suicide attempts are extremely rare.

The PATH surveys contain a lot of questions about people’s employment status and financial position, and this is where Butterworth has conducted much of his own analysis.

Contrary to accepted wisdom, one of his graphs shows that money can buy happiness, although the effect begins to plateau as annual salaries approach $100,000.

“One in three people in the poorest households experience depression at any point in time, whereas amongst the wealthier households the corresponding figure is about five per cent, or one in 20,” Butterworth says.

As well as how much we’re paid, it’s not surprising that our experiences at work – where most of us spend most of our time – also plays a huge part in our mental health.

“Exposure to bullying at work is associated with at least doubling, and in some cases trebling the risk of depression and anxiety, and also doubles the risk of having suicidal thoughts,” says the professor.

He’s also investigated the link between mental health and the number of “adverse conditions” at work, like job insecurity, excessive demands and having little or no autonomy.

Interestingly, those in the least enjoyable jobs had poorer general and mental health than those who were unemployed.

Butterworth leads a research unit looking at social issues in mental health across the populace, and says depression and anxiety are in fact the biggest cause of disability worldwide.

“We’ve demonstrated in PATH [how] social circumstances, social experiences and the environmental impact of the world around people, is causally related to their mental health,” he says.

“Mental health at a community level, I think, provides some sort of a marker of how well a society’s doing, overall.”